Ultrasonic medical device

Abstract

Ultrasonic devices for preventing microbubbles and/or microparticles from reaching the brain during a PCI, or cardiovascular surgery. Devices 27 and 77 are designed for implantation in the chest cavity and operate in combination with needle vents or other vent systems for removing diverted microbubbles. Systems 77 and 83 are designed for noninvasive employment. Devices 57 and 87 are particularly designed to prevent microbubbles from reaching the great origins of the carotid arteries and/or for diverting bubbles that might reach the vicinity and otherwise pass through. Improved devices 11 and 94 separate microbubbles from a flowing bloodstream and produce a cleansed stream.

1. A medical treatment device for preventing microbubbles and/or microparticles from entering the neck vessels of a patient comprising
 collar means for association with the exterior of the neck of a patient undergoing treatment which might give rise to the creation of microbubbles and/or microparticles in the bloodstream, which collar means contains multiple transducers in selected locations such that they will focus ultrasonic waves that are generated in a collar region of the patient at the exterior of the neck and direct them downward and inward at both great origins of the neck vessels at the arch of the aorta, and  
 means for powering such transducers so as to send ultrasonic waves that cause microbubbles and/or microparticles to deviate within the flowing bloodstream so as not to enter said great origins and instead travel to the lower part of the patient's body.  
 
   
   
     2. The medical treatment device according to  claim 1  wherein there is provided an auxiliary pad means for association with the right and left sides of the neck of the patient generally adjacent said collar means and just upstream of the location where the carotid artery splits into the external and internal carotids. 
   
   
     3. A method for treating a patient undergoing cardiac surgery or a percutaneous cardiological intervention so as to prevent microbubbles and/or microparticles in the blood of the patient from entering the neck vessels of the patient which method comprises the steps of:
 directing ultrasonic waves into the ascending aorta of the patient, and  
 focusing such waves to direct microbubbles and/or micropartircles toward a wail of the ascending aorta.  
 
   
   
     4. The method according to  claim 3  wherein said ultrasonic waves are generated in a collar region of the patient at the extension of the neck and directed downward and inward at both great origins of the neck vessels at the arch of the aorta so as to cause microbubbles and/or microparticles to deviate within the flowing bloodstream so as not to enter said great origins and instead travel to the lower part of the patient's body. 
   
   
     5. A method according to  claim 3  wherein:
 said ultrasonic waves are focused into the ascending aorta of the patient to direct microbubbles and/or microparticles so they will reach a region along the anterior wall of the ascending aorta, and  
 said microbubbles and/or microparticles are withdrawn from the bloodstream through vent means which is extended through the anterior wall of the aorta.  
 
   
   
     6. The method according to  claim 5  wherein said ultrasonic waves are generated from transducers carried by an esophageal probe inserted into the patient's esophagus and positioned at a location adjacent the ascending aorta and the left ventricle of the heart. 
   
   
     7. The method according to  claim 5  wherein said ultrasonic waves are generated from transducers carried by an endotracheal tube inserted into the patient's trachea and positioned at a location adjacent the aortic arch. 
   
   
     8. The method of treatment according to  claim 5  wherein said ultrasonic waves are generated by transducers carried in a flexible pad which is positioned below the heart of the patient so that the heart rests thereupon during surgery. 
   
   
     9. The method of treatment according to  claim 5  wherein said ultrasonic waves are generated by transducers carried by a pad which is adhered to the back of the patient in the region of the left ventricle and the ascending aorta. 
   
   
     10. The method of treatment according to  claim 5  wherein said ultrasonic waves are generated by transducers located within the chest cavity of the patient at a location just downstream of the aortic valve. 
   
   
     11. A medical treatment device for removing microbubbles and/or microparticles from a patient's bloodstream, which device comprises
 transducer means for association with the exterior surface of the posterior side of the aorta in the general region of the transverse sinus,  
 means for powering said transducer means to generate ultrasonic waves that are directed toward the anterior side of the aorta,  
 sidestream-removal means for insertion into the anterior side of the aorta downstream of the transverse sinus, and  
 means for removing blood and microbubbles and/or microparticles through said sidestream-removal means.  
 
   
   
     12. The medical treatment device according to  claim 11  wherein means is provided f or holding said transducer means in physical contact with the exterior surface of the aorta. 
   
   
     13. The medical treatment device according to  claim 12  wherein said holder means includes a spring-like support that fits more than 180° about the aorta. 
   
   
     14. The medical treatment device according to  claim 13  wherein expandable balloon means is located between said support and said transducer means to hold said transducer means firmly against the exterior surface of the aorta. 
   
   
     15. The medical treatment device according to  claim 11  wherein said sidestream-removal means is formed integrally with an arterial-line cannula for returning blood from a heart-lung machine to the aorta downstream of the aortic valve so as to constitute a double-lumen cannula. 
   
   
     16. The medical treatment device according to  claim 15  wherein said double-lumen cannula has a main passageway through which incoming blood exits downstream and a smaller lumen passageway having an opening which faces directly upstream. 
   
   
     17. A method for controlling flow in a blood vessel in a body of a patient, the method comprising:
 positioning one or more ultrasonic transducers to be appropriately located and associated with the body of a patient; and  
 actuating at least one such transducer to transmit ultrasonic waves toward the blood vessel, which branches into at least a first branch vessel, so as to cause at least one of microbubbles and microparticles that may be flowing in blood in the blood vessel to be deflected away from the first branch vessel.  
 
   
   
     18. The method according to  claim 17 , wherein said positioning the one or more ultrasonic transducers comprises placing at least one transducer adjacent to the patient's neck. 
   
   
     19. The method according to  claim 18 , wherein the blood vessel is a common carotid artery, and wherein said positioning the one or more ultrasonic transducers comprises aiming at least one transducer toward a location in the body upstream of where the common carotid artery splits into internal and external carotid arteries so as to cause the at least one of the microbubbles and microparticles to be deflected away from the internal carotid artery. 
   
   
     20. The method according to  claim 18 , wherein positioning the one or more ultrasonic transducers comprises aiming at least one transducer toward an aortic arch of the patient at a location of a great origin of a neck vessel so as to cause the at least one of the microbubbles and microparticles to be deflected away from the branch vessel which is a neck vessel. 
   
   
     21. The method according to  claim 17 , wherein said positioning the one or more ultrasonic transducers comprises positioning at least one transducer within a chest cavity of the patient adjacent to the ascending aorta, and aiming the at least one transducer into the ascending aorta so as to cause the at least one of the microbubbles and microparticles to be deflected away front a great origin of a neck vessel. 
   
   
     22. The method according to  claim 17 , wherein said actuating comprises actuating at least one transducer according to a wave pattern selected so as not to substantially heat flesh of the patient. 
   
   
     23. A device for controlling flow in a blood vessel in a body of a patient which branches into at least a first branch vessel, said device comprising:
 a collar which is adapted to be placed around the patient's neck; and  
 one or more ultrasonic transducers, fixed to the collar so as to be positioned in a selected location relative to the body when the collar is placed around the neck, and adapted, while so positioned, to transmit ultrasonic waves toward the blood vessel, so as to cause at least one of microbubbles and microparticles that may be flowing in blood in the blood vessel to be deflected away from the first branch vessel.  
 
   
   
     24. The device according to  claim 23 , wherein the blood vessel is a common carotid artery, and wherein at least one said transducer is adapted, when the collar is placed around the neck, to transmit the ultrasonic waves toward a location in the body upstream of where the common carotid artery splits into internal and external carotid arteries so as to cause the at least one of the microbubbles and microparticles to be deflected away from the internal carotid artery. 
   
   
     25. The device according to  claim 23 , wherein the blood vessel is an aortic arch of the patient and wherein at least one said transducer is adapted, when the collar is placed around the neck, to transmit the ultrasonic waves toward the aortic arch at a location of a great origin of a neck vessel so as to cause the at least one of the microbubbles and microparticles to be deflected away from the neck vessel. 
   
   
     26. The device according to  claim 23 , which includes a controller that is adapted to actuate at least one of the one or more transducers according to a wave pattern selected so as not to substantially heat flesh of the patient. 
   
   
     27. A device for controlling flow in an aorta in a chest cavity of a patient which device comprises:
 a holder, which is adapted to be placed in the chest cavity in association with the aorta; and  
 one or more ultrasonic transducers, which are adapted to be fixed by the holder in proximity to the aorta and to transmit ultrasonic waves into the aorta which waves have sufficient power so as to cause at least one of microbubbles and microparticles flowing in the aorta which are so affected by said ultrasonic waves to be deflected away from a great origin of a neck vessel.